護理師衛教新處方 Levothyroxine 的病人，應包含哪些資訊？（選所有適合的）
A nurse is teaching a client about a new prescription for Levothyroxine. Which information should the nurse include? (Select all that apply.)
- ATake the medication at bedtime with a snack睡前搭配點心服用藥物
- BTake the medication on an empty stomach in the morning✓ 正解早晨空腹服用藥物
- CTreatment is usually lifelong✓ 正解治療通常是終身的
- DReport symptoms of palpitations or insomnia✓ 正解報告心悸或失眠症狀
- EIt may take several weeks to feel the full effect✓ 正解可能需要數週才能感受到完整療效
Levothyroxine（合成甲狀腺素）是治療甲狀腺功能低下（Hypothyroidism）的標準藥物。這類藥物的吸收極易受食物、鈣、鐵等物質影響，因此核心衛教是「早晨空腹服用」，且需在進食前 30-60 分鐘。由於甲狀腺功能低下通常是永久性的（如橋本氏甲狀腺炎或手術切除後），病人需理解這通常是終生治療。護理師還需告知病人藥效並非立竿見影，可能需要 4-6 週才能達到血中穩定濃度。最關鍵的安全教育是識別「甲狀腺功能亢進」的症狀（如心悸、失眠、體重減輕），這代表劑量可能過高，需及時回報調整。
Levothyroxine (synthetic thyroxine) is the standard treatment for hypothyroidism. The absorption of this drug is easily affected by food, calcium, iron, and other substances; therefore, the core teaching is "take in the morning on an empty stomach," 30–60 minutes before eating. Because hypothyroidism is usually permanent (such as in Hashimoto's thyroiditis or after surgical removal of the thyroid), patients must understand that treatment is generally lifelong. The nurse should also inform the patient that the drug does not produce an immediate effect and that 4–6 weeks may be required to reach a stable serum level. The most critical safety teaching is recognition of hyperthyroid symptoms (such as palpitations, insomnia, and weight loss), which suggest the dose may be too high and should be reported promptly for adjustment.
在美國，Levothyroxine 是處方量排名前三的藥物，護理師對其給藥細節（如早上 6 點給藥）要求極嚴。台灣臨床有時未嚴格要求空腹時間，但在 NCLEX 考試中，必須堅持「空腹」與「與其他藥物間隔」的原則。